Epi Bulletin
Well-Child Checkups
1
2016 Immunization
Schedules
1
2
Children with Disabil2-3
ity
Communicable Disease Summary
3
References
3
Comm. Disease Data
Produced by the Section of Health Planning and Policy
March 2016
Volume 9, Issue 3
Prevention is Key to Wellness - Maximize the Benefits of Well-Child Checkups
Inside this issue
Administration Error
Meningococcal Vaccine
A newsletter for healthcare professionals in Clay County
4
A well-child checkup is a preventive doctor’s visit for children, up to 17. It provides a general wellness evaluation
of a child, including a growth and developmental assessment, immunization update and opportunities for parents
to share any health concerns and/or ask questions, etc.
A well-child checkup could be what the patient, the provider and the family makes it to be, but most importantly it
provides opportunities for routine medical checkup for a
child. A potential health issue caught early in a child’s life
can make a big difference on what the future outcomes
and the quality of life for the child would be.
There are many reasons a child may not make it to a well-child checkup. Some reasons
include; lack of health care coverage, parent’s inability to pay the co-payment, parent’s
health literacy level, distance to a medical facility or provider. Most parents understand
and utilize the opportunities provided by a well-child checkup; however, some parents do
not understand the importance of a doctor’s visit for a child that is neither ill nor needing
medical attention.
Current CDC report shows that, “From 2008 to 2014, the percentage of youths aged 1017 years who had not received a well-child checkup in the past 12 months decreased
overall (31.3% to 21.2%) and in both metropolitan (29.3% to 20.1%) and nonmetropolitan
(41.8% to 28.2%) areas. In 2014, youths aged 10-17 years residing in nonmetropolitan
areas were more likely to have not received a well-child checkup in the past 12 months
compared with those residing in metropolitan areas.” 1
To continue to encourage parents to bring their children in for this important visit, parents
should be reminded at each visit when the next well-child checkup visit is expected to be.
If possible, appointment should be scheduled while the family is still in the clinic, and followed up with an appointment reminder to encourage actions.
C l a y C o u n t y P u b li c
Health Center
ACIP Releases 2016 Immunization Schedules
The 2016 Immunization Schedule Updates are now available. Providers should use both
the recommended schedules and the catch-up schedules with their footnotes. We encourage you to update all immunization schedules used within your practice and check
the CDC website regularly to make sure you are using the most current and accurate
schedules. Please visit the following link for the updated PDFs of the new schedules:
http://www.cdc.gov/vaccines/schedules/hcp/index.html
Laminated 2016 schedules will be available from the Immunization Action Coalition website:
http://www.immunize.org/shop/laminated-schedules.asp
Epi Bulletin
Page 2
Beware of Administration Error Involving Meningococcal Conjugate
Vaccine
Recently, an immunization provider administered only the lyophilized
component of Menveo, then administered a properly prepared dose of
Menveo to the same patient. This provider asked CDC if this practice was
safe. The question prompted CDC to search the Vaccine Adverse Event
Reporting System (VAERS) database for reports during March 1, 2010–
September 22, 2015, of only one component of Menveo being administered. The Food and Drug Administration also performed data mining with
empiric Bayesian methods to more broadly identify disproportional reporting of adverse events in general following Menveo immunization compared with other vaccines in VAERS.
Based of the outcome of that search, it is recommended that vaccination
providers follow the instructions provided with Menveo (including vaccine
labeling, packaging and product insert) regarding proper administration.
Vaccines requiring reconstitution should only be reconstituted with the
specific diluent supplied by the manufacturer for that vaccine. A recipient
who receives an improperly prepared dose of Menveo should receive a
repeat dose of meningococcal conjugate vaccine prepared according to
manufacturer instructions; this repeat dose can be administered at any
time.
Storage and Handling of Meveo Vaccine: Do not freeze, frozen/previously frozen product should not be used. Store refrigerated, away from the freezer compartment, at 36°F to 46°F (2°C to 8°C) and protect from light. Vaccine must be maintained at
36°F to 46°F during transport. Do not use after the expiration date. The reconstituted vaccine should be used immediately,
but may be held at or below 77°F (25°C) for up to 8 hours. 2
Working/Raising a Child with a Disability: Efforts in Cultural Competency
Tips from the National Center on Health, Physical Activity and Disability (NCHPAD)
Step 1: Creating a Positive Self-Image 3

Help a child with a disability to identify him/herself as a person first and not with their disability.

Avoid having the disability top the list of discussions around a child with a disability, even in medical settings like doctor’s
visits or appointments. A disability has a direct relationship to a person’s self-image.

Encourage positive views and do things to show a child that their disability is not negative.

Try as much as possible to treat a child with disability as their peers. Look at other children of their age, and help them
identify with their peers; their dressing, what characteristics that define them, etc. Helping your child with a disability dress
age appropriately could go a long way in helping them to find their self-identity.

Take a look at their mobility device, if they use one, determine if they are age appropriate.
Step 2: Promote Self-Determination

4
Provide opportunities for a child with a disability to make choices. This will help enhance a higher internal state of control,
and would positively affect their state of wellness and self-determination. The more control someone believes they have
over something, the more empowered they feel to have the ability to change it or other areas in their life .
Epi Bulletin
Page 3
Working/Raising a Child with a Disability: Efforts in Cultural Competency
Contd.

Ask questions that empower rather than giving a command. Command statements often lead to a defiant response.
Step 3: Teach Problem Solving 5

When speaking with or addressing a child with a disability, avoid using words like obstacles or barriers. This is because you
do not want someone with a disability to see challenges as a stop sign or something that they cannot get past with a little
ingenuity. Instead, we can encourage them to see challenges as a kind of puzzle they have to learn to figure out.

Help children with a disability to develop problem solving skills. This will help children to gain confidence, since these skills
are especially important for children with a disability as they will face obstacles and barriers for the rest of their life and will be
prepared to handle them successfully to gain independent.

Do not try to avoid challenging situations or rectify them as soon as possible. This does not allow the child to learn on his/her
own and to build needed skills. Most children with a disability will one day be an adult and will need to learn how to navigate
some situations on their own.
Clay County Communicable Disease Data Summary
The 2016 year-to-date disease report for MMWR Week 8 shows that gastrointestinal diseases; campylobacteriosis, shigellosis
and salmonellosis are above what is expected for the county for this time period. Other diseases above expected levels are strep
disease group A invasive, strep pneumonia drug resistant diseases and legionellosis.
Shigellosis outbreak is still active in the metro area including Clay County. We encourage physicians to continue to evaluate and
consider recommending testing for individuals with diarrhea illnesses for proper diagnosis, treatment and community containment.
Please note that children in day care settings need to have testing done for proper diagnosis. This helps in proper exclusion and readmission of children back to day care as required by the State Bureau of Communicable Disease and the
State Child care Licensing Office.
Flu activity continues to increase. For the week 8, the county flu count more than doubled than what was seen in week 7. The
Health Center continues to recommend that we all practice proper hand washing, sneezing and coughing hygiene to help prevent
the spread of diseases.
To access the most current information on Zika virus, please follow the link below to CDC Zika virus website.
http://www.cdc.gov/zika/index.html
References and Links
1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6452a6.htm?s_cid=mm6452a6_w
2. http://www.cdc.gov/mmwr/volumes/65/wr/mm6506a4.htm?s_cid=mm6506a4_e
3. http://www.nchpad.org/1416/6301/Five~Steps~for~Raising~a~Child~with~a~Disability
4. http://www.nchpad.org/1442/6347/Five~Steps~to~Raising~a~Child~with~a~Disability
5. http://www.nchpad.org/1451/6369/Five~Steps~to~Raising~a~Child~with~a~Disability~~Step~3~
2016 Epidemiological Weeks
Week 5 Week 6 Week 7 Week 8 YTD 2016
5-Year
Mean
5-Year Median
HIGH PRIORITY REPORTING
DISEASES
Q Fever
Brucellosis
Yersinosis
GASTROINTESTINAL DISEASES
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Acute Hep A
0
0
0
0
0
0
0
Campylobacteriosis
1
0
0
0
2
0
0
Cryptosporidiosis
0
0
0
0
0
0
0
Cyclosporiasis
0
0
0
0
0
0
0
E.Coli O157H7
0
0
0
0
0
0
0
E.Coli Shiga Toxin
0
0
0
0
0
0
0
Giardiasis
0
0
0
0
0
0
0
Listeriosis
0
0
0
0
0
0
0
Salmonellosis
1
0
0
0
3
1
1
Shigellosis
1
0
0
0
8
0
0
Vibrosis
0
0
0
0
0
0
0
Hep B (Acute)
0
0
0
0
0
0
0
Hep B Pregnancy (prenatal)
0
0
0
0
0
0
0
Haemophilus Influenza, Invasive
0
0
0
0
0
0
0
Pertussis
Meningococcal
Measles
Mumps
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Varicella (chickenpox)
0
0
0
0
1
0
0
VACCINE PREVENTABLE
DISEASES
0
TICKBORNE DISEASES
Ehrlichia Chaffensii (HME)
0
0
0
0
0
0
0
Ehrlichiosis HGE
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
OTHER RESPIRATORY DISEASES
Coccidioidomycosis
Influenza/ILI
Legionellosis
0
1
0
0
7
0
0
27
0
0
73
0
0
119
1
0
n/a
0
0
n/a
0
Tuberclosis Diseases (TB)
0
0
0
0
1
0
0
VECTOR BORNE DISEASES
Malaria
0
0
0
0
0
0
0
1
0
1
0
3
1
0
Strep Pneumonia < 5 years
Invasive
0
0
0
0
0
0
0
Strep Pneumonia Drug Resistant
0
0
0
0
1
0
0
Toxic Shock Syndrome
0
0
0
0
0
0
0
Ehrlichia Anaplasmosis Undetermined
Lyme Disease
Rocky Mountain Spotted Fever
Tularemia
OTHER DISEASES
Strep Disease Group A Invasive
To access data from the Missouri Department of Health and Senior Services, click the following link for STD: LINK
For TB data, click the following LINK
Reported disease are confirmed and probable cases except for Influenza (all reported cases). Cases are reported by MMWR Week and by Diagnosis Date, since not all cases has a known
onset date. Each disease case count may not match with the actual number of the disease reported for Clay County. The case counts continually change as cases are reported, investigated,
reclassified, or closed. This does not represent the total number of cases investigated.
Epi Bulletin Contributors: Dr. Ximena Somoza, MPH; Nkolika Obiesie, DVM, MPH; Corrie Courtney, MPH, BSN, RN; Jody Light, BSN, RN; Wennekota Tarama, MPH,
MBA; Cindy St John